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However, even though we did not performed hormone level test, the imbalance in the gender ratio and more than 50% of patients with onset ages within the reproductive ages of 20~49 years old in this study suggests that sex hormones play a role in pathogenesis of PFPT, and the high incidence of concomitant pigmentary disorder suggests that patients with PFPT have susceptibility to abnormal pigmentation

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The buildup of BCAAs may lead to cardiac enlargement and contribute to the progression of hypertension and coronary heart disease (70, 71)